Evidence map›Paper›PMID 42493692›Full record

ArticleDigestive diseases and sciences2026

The COMPLETE-CRC Screening Initiative: Increasing Colonoscopy Completion After Positive Stool-Based Colorectal Cancer Screening.

Akram Abushamma, Susannah Wolfe, Gabriella Lakatos, Yueqi Wu, Carole Macaron

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Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Akram AbushammaDepartment of Internal Medicine, Cleveland Clinic Akron General, Cleveland Clinic, Akron, OH, USA.
Susannah WolfeDepartment of Gastroenterology, Hepatology, and Nutrition, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA.
Gabriella LakatosDepartment of Gastroenterology, Hepatology, and Nutrition, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA.
Yueqi WuDepartment of Qualitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
Carole MacaronDepartment of Gastroenterology, Hepatology, and Nutrition, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA. MACAROC@ccf.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStool-based tests (SBTs) are increasingly used for colorectal cancer (CRC) screening; however, follow-up colonoscopy rates after positive results remain suboptimal.

aimsTo reach colonoscopy completion rates of ≥ 80% within 6 months of patient navigator contact among all Ohio patients with positive SBTs in the year prior to contact and to identify factors associated with completion.

methodsThis quality improvement study included adults aged 45-75 years with positive SBT between August 1, 2023, and August 1, 2024, at Cleveland Clinic. Patients who had not completed a colonoscopy within 360 days of a positive SBT were contacted by a patient navigator via phone and/or the patient portal (MyChart) to address the importance of colonoscopy, scheduling, and documented barriers. Patients were classified as direct contact if they answered a telephone call or a MyChart message, and as indirect outreach if neither occurred. The primary outcome was colonoscopy completion 6 months after navigator contact. Multivariable logistic regression was used to assess factors associated with completion.

resultsOf 2,548 patients with positive SBT, 803 (31.5%) had not completed colonoscopy within 360 days. Among 476 Ohio patients, 144 (30.3%) had direct contact and 332 (69.7%) had indirect outreach; 31 underwent colonoscopy, and 26 were scheduled for colonoscopy, increasing overall colonoscopy completion rates from 68.5% to 70.2%. Among 47 patients, reported barriers included limited knowledge (31.9%), transportation challenges (31.9%), prior negative experiences (10.6%), fear (8.5%), cost concerns (4.3%), and communication gaps (6.4%). Direct patient contact was associated with significantly higher colonoscopy completion than indirect outreach (16.7% vs 2.1%; p < 0.001). In univariable analysis, increasing age was associated with lower odds of completion after outreach (OR 0.94; 95% CI 0.90-0.98; p = 0.004) and remained significant after adjusting for race and insurance (aOR 0.94; 95% CI 0.90-0.98; p = 0.007).

conclusionsPatient outreach was associated with increased colonoscopy completion after a positive SBT, whereas older age was associated with lower completion rates. Despite improvements, completion remained suboptimal, underscoring the need to optimize CRC screening outreach. CLINICAL TRIAL NUMBER: not applicable.

Indexed as

ColonoscopyColorectal NeoplasmsEarly Detection of CancerPatient ComplianceAgedFemaleHumansMaleMiddle AgedOccult BloodOhioPatient NavigationQuality ImprovementColonoscopyColorectal cancerPatient navigationScreening

Identifiers

PMID42493692
PMCPMC13585876

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.